When Organizations Change Their Language Overnight, They Break Community Trust.

Key Takeaways

• Organizations across the country removed words like "equity" and "justice" from their websites in early 2025 without consulting community partners
• The speed of these changes, rather than the word changes themselves, damaged relationships built over years
• Community engagement requires co-equal partnerships, shared governance, and ongoing bidirectional communication
• Public opinion data shows surprising cross-ideological agreement on health equity policies when framed differently
• Health equity benefits all communities, including white communities often left out of the conversation

The LinkedIn Post That Captured a Crisis

Dr. Philip Alberti posted a single sentence on LinkedIn that stopped health equity professionals in their tracks: "The more our organizations change their language, the less their communities trust them."

This observation captures what happened across healthcare systems, public health departments, and universities in early 2025. Organizations scrubbed their websites. Terms like "health equity," "racial justice," and "systemic racism" disappeared overnight. Leadership changed job titles. Entire departments vanished.

The threats were real. Federal funding hung in the balance. Jobs were at stake. Personal safety became a concern for some professionals. These existential pressures created an understandable panic.

But something else happened in that panic. Organizations made unilateral decisions to change their language without the communities they had partnered with for years. That choice sent a message nobody intended: when pressure comes, your voice matters less than our survival.

Why Speed Matters

Dr. Alberti directs the AAMC Center for Health Justice, where he focuses on community-engaged research and policy change. His background includes work in public health departments and academic medical centers. He entered this field thinking about class-based inequities and LGBTQ+ health disparities as a gay man navigating systems that often excluded people like him.

From his position working with community partners nationwide, Alberti saw a pattern in how organizations responded to political pressure. "Organizations complied even before they were necessarily asked or forced to," he explains. "The lack of community engagement in crafting the new language and thinking through those changes" created the real damage.

Community members and patients understand the political landscape. They watch the news. They see what's happening. The threats were never hidden. What caught them off guard was being excluded from strategy discussions about how to respond to those threats.

The automatic compliance without engagement signaled a lack of commitment to the work. It showed a lack of respect for partnerships. When organizations moved that fast, they revealed what mattered most when stakes got high.

What Communities Actually Said

Community responses varied widely because communities themselves vary widely. A demographic community differs from a geographic community or a community defined by shared interests. Within any single community, diversity creates different perspectives and reactions.

But Alberti heard consistent themes from community partners, patients, scientists, and academics. They noticed the speed. They felt the absence of conversation. They understood they had been cut out of decisions about work they helped build.

One community member framed it plainly: these words were never illegal. The rush to remove them created an atmosphere of fear that went beyond what was actually required. Organizations acted as if saying "equity" had become a swear word.

The exclusion from decision-making hurt more than the word changes themselves. Years of partnership building apparently meant little when organizational survival felt threatened. Community partners had invested time, expertise, and trust. They deserved a seat at the table when strategies shifted.

The Health Equity Tourists Left

Some positive outcomes emerged from this crisis. The field saw what Alberti calls "health equity tourists" exit immediately. These were professionals who joined the health equity movement when money flowed and the topic was hot, particularly around COVID-19. When the light dimmed and the money dried up, they jumped ship.

Their departure might benefit the field long-term. The core group of people committed to this work over decades stayed. They weathered the storm because their commitment ran deeper than funding cycles or political trends.

This moment forces reflection. Health equity benefits every community. If that's true, how did this concept become so divisive in 2025? Where did the field lose the thread?

The answer requires listening carefully to people whose values run perpendicular to health equity goals. What are they saying about this work? What do they misunderstand? What have they mischaracterized?

Then comes harder introspection. How did health equity advocates make their arguments easier to attack? From measurement approaches to messaging to narratives, where did the field create vulnerabilities?

The Question of Who Benefits

A 2021 editorial by a former U.S. cabinet member made two bold claims about health equity work. First, that the work is racist, exclusionary, and discriminatory because it focuses too heavily on racial and ethnic inequities. Second, that health equity work is un-American because it mandates equal outcomes instead of equal opportunities.

Both claims represent either misunderstandings or mischaracterizations, depending on how generous you want to be. The Centers for Disease Control and Prevention definition of health equity centers on opportunity: "Health equity is achieved when everyone has a fair and just opportunity to attain their highest level of health." Opportunity sits at the foundation of this work.

The health equity tent has always been large. It includes work on class-based inequities, LGBTQ+ health disparities, rural health access, and many other dimensions beyond race and ethnicity. But COVID-19 revealed stark racial health inequities developing in real-time. The Black Lives Matter movement gained momentum. The field appropriately focused attention on racial and ethnic health disparities in ways it hadn't before.

That focus created an opening for critics to claim the field only cares about Black, Brown, and Indigenous communities. The claim was false, but it stuck.

Alberti addresses this directly in his article "Health Equity Benefits All Communities, Even White Ones." The title itself provokes necessary conversation. White communities face health inequities too. Rural white communities struggle with healthcare access. Working-class white communities face economic barriers to health. White LGBTQ+ communities navigate discrimination in healthcare settings.

Acknowledging these realities does not minimize racial health inequities. It does not water down the focus on systemic racism in healthcare. It expands the understanding of who benefits when communities have fair and just opportunities to achieve health.

The Zero-Sum Game Myth

A harmful false narrative exists in American society: health and economic resources exist in finite pools. If one group's outcomes improve, another group's outcomes must decline. Winners require losers.

This zero-sum thinking poisons health equity work. When 40% of society believes that narrowing health gaps means their communities must lose for other communities to gain, even measurement approaches reinforce damaging narratives.

Health equity progress gets measured by watching gaps narrow. If Group A has an infant mortality rate of 10 per 1,000 births and Group B has a rate of 5 per 1,000 births, success means bringing Group A's rate down to match Group B. That's the standard measurement approach.

But to people trapped in zero-sum thinking, closing that gap sounds like Group B's rate must rise to meet Group A. They hear "narrowing gaps" and assume their community will suffer. The measurement language itself feeds misunderstanding.

There are no losers in a health equity system. Enough resources exist. Everyone can thrive. But the way the field talks about progress obscures that reality.

Who Builds the Bridges

Alberti makes a clear point: we cannot ask Black and Brown health equity champions to build bridges with people who question their right to exist safely in society. That work threatens mental health. It demands emotional labor that is unfair and unsafe to require.

White health equity champions need to step into this gap. Progressive, equity-minded white people need to have conversations with their families, friends, and neighbors. They need to engage in spaces where Black and Brown advocates cannot safely go.

Alberti imagines an organization he jokingly calls "The Daves" after his two brothers-in-law. One comes from a military background in Texas. The other comes from rural Delaware. Both are white heterosexual men deeply committed to progressive values and health equity thinking.

What would it mean to galvanize health equity-minded heterosexual white men? Train them to communicate across divides. Support them in building bridges in places where other advocates cannot comfortably or safely enter. Leverage every ally in this movement according to where they can create the most impact.

The field needs different messengers for different audiences. Strategic thinking about who delivers which messages to which groups strengthens the overall movement.

What Remains Non-Negotiable

No specific word is non-negotiable. Alberti spends hours every day negotiating language with his boss, their boss, teams, and partners. Threading narrowing needles with careful word choices has become daily work in 2025 and beyond.

Words can change. Thesauruses exist for a reason. If "justice" must become "fairness" to keep the work alive, that substitution can happen.

But processes and values remain non-negotiable. How organizations make changes matters as much as what changes they make.

The National Academies created a model for assessing meaningful engagement. At its center sits a green circle containing 10 core principles of authentic engagement: co-equal partnerships, equitable financing, shared governance, ongoing relationships, bidirectional knowledge flow, and more.

These principles define the non-negotiables. Organizations can change their words, but they must maintain these values in how they make those changes.

Imagine an alternative timeline. Academic health systems, public health departments, and universities face the same political pressures. But before scrubbing websites, they contact community partners. They explain the threats in detail. They ask for input on how to respond while maintaining commitment to shared values and processes.

Together, organizations and communities look at web pages for projects they've built over five or six years. They negotiate language changes. They figure out how to telegraph ongoing commitment to values and processes even while adjusting words.

That co-creation process becomes a vehicle to recommit to each other and to the work. The changes still happen, but trust deepens instead of breaking.

How to Start Building Community Partnerships

Organizations fall into three categories when it comes to community engagement. Some do it exceptionally well. Some never think about it. Some want to do it but don't know where to start or who to contact.

The benefits of authentic engagement start with stronger alliances. When a crisis hits (a pandemic, a natural disaster, a policy emergency), established networks of trusted partners can mobilize immediately. Compare that to scrambling to build partnerships during a crisis when community members rightfully give you suspicious looks.

Strong community engagement produces better knowledge for everyone. The flow goes both directions. Organizations don't just educate communities. Communities educate organizations. That bidirectional learning creates better programs, better policies, and more sustainable solutions.

When communities help build policies and practices, those changes embed more deeply. Buy-in exists at multiple levels. Communities advocate for their own solutions because they helped create them. That advocacy opens pathways to organizational, local, state, and federal policy changes that create new fair and just opportunities where none existed before.

Starting community engagement requires one primary action: listen. Go to places and listen. Don't speak. Ask questions and listen. Break bread together. Listen to everyone, especially people you disagree with. Look for common ground. Understand their goals. Build relationships for the sake of relationships, not for any specific ask or agenda.

Over time (and this work requires a long arc), relationships deepen. Then you can build together.

The Institutional Barriers

Organizations make this human work of relationship building unnecessarily hard. Institutions lack infrastructure, organizational culture, and practices to support authentic community engagement.

Consider practical examples. Paying community partners should happen at rates equivalent to external consultants. But getting that payment processed often requires W-2s and tax forms. How easy does your organization make that payment process? Usually not very easy.

If you want community members as formal co-investigators on research projects, does your institutional review board understand what that means? Do their forms allow for it? Can they process community partners who don't have traditional academic credentials or institutional affiliations?

Whose job is it at your organization to build, maintain, and sustain community partnerships in the absence of a specific grant or project? Who stays connected to community members just to have that network without expectations or asks? Who gets evaluated and held accountable for that relationship work?

Most organizations answer "nobody" to those questions. Without dedicated roles and resources for relationship building that exists independent of specific projects, authentic partnerships remain impossible.

Organizations need to examine their policies, practices, and culture. They need to remove barriers that make community engagement harder than it should be. They need to create positions and allocate resources specifically for this work.

What the Data Shows

The AAMC Center for Health Justice conducts extensive public opinion polling. Their recent research offers surprising hope. They surveyed nationally representative samples of U.S. adults about the Vital Conditions for Health and Well-being: humane housing, reliable transportation, sense of belonging, thriving natural world, and other fundamental building blocks.

Universal agreement emerged. Every demographic group, every generation, every political persuasion agreed these conditions matter for their own community's health and wellbeing. The data showed no significant variation.

Yes, people might disagree about whether other communities deserve those things. Yes, people disagree about why not all communities have those things. But at a fundamental level, everyone agrees their own community would benefit.

That agreement creates a starting point for conversation.

More surprising findings emerged from other polls. Seventy-five to seventy-seven percent of conservative members of Generation Z said healthcare is a human right. That represents a shocking area of cross-ideological agreement.

A poll on civic engagement found nonpartisan cross-ideological agreement on increasing polling locations and establishing codes of conduct for Supreme Court justices. These represent ways to strengthen democracy where real agreement exists across traditional divides.

Even on contentious issues like reparations for populations descended from formerly enslaved people, researchers found cross-party and cross-ideological agreement when they presented policies without explicitly mentioning racial justice or reparations. They used policies from California's reparations report but didn't identify them as such.

Policies like increasing funding for public education, creating voter registration opportunities for high school students, and conducting environmental health screenings for all communities gained broad support. The policies themselves attracted agreement. The framing determined whether people supported or opposed them.

This data validates a crucial point: how the field frames and discusses health equity goals either increases or decreases support. The work of rethinking communication approaches matters enormously.

Building Across Divides

A recent article in The Nation highlighted an organization called Community Works. Their model offers a blueprint for building cross-ideological relationships. In hyperlocal spaces, they bring together people across political ideologies and racial and ethnic groups for one purpose: community service work.

No policy conversations. No organizing. No proselytizing. No soapboxes. Just coming together to work for the benefit of the place everyone calls home.

The outcomes include increased energy, enthusiasm, and social cohesion. People develop a stronger sense of belonging to place. Creating opportunities for people to simply be people together and build relationships outside political or ideological divisions shows real promise.

That relationship foundation can later support harder conversations about policy and systems change. But it starts with human connection around shared commitment to place.

Health Justice as Framework

Health justice functions as both aspiration and operational framework. The AAMC Center for Health Justice defines their process as keeping one foot in community wisdom and multi-sector partnership. That grounds the work of the other foot: co-creating data, stories, and evidence across community groups and sectors.

That co-created evidence gets baked into policy and practice changes. Those changes move communities toward the goal of all communities thriving.

One of the Center's mantras captures this approach: the process is as important as the product. If the goal is all communities thriving, focusing on the health justice process that demands humility and authentic engagement with community members and different sectors makes the process both the action and the aspiration.

That virtuous cycle of trustworthiness, engagement, and collaboration produces outputs beyond what anyone can imagine. Those outputs extend beyond the goal of all communities thriving. The engine of authentic partnership yields benefits across every area of work.

Moving Forward in 2025 and Beyond

The current political landscape creates real threats to health equity work. Funding disappears. Jobs end. Safety concerns arise. These realities cannot be minimized or dismissed.

But this moment also creates opportunity. The field can regroup without losing core values or partnerships. Advocates can maintain community-engaged positions while asking tough questions about how to make the case more effectively that health equity means all communities thriving.

Organizations face a choice in how they navigate pressure to change language. They can make unilateral decisions that break trust. Or they can engage communities as co-equal partners in figuring out how to respond to threats while maintaining commitments.

The word choices matter less than the process of making those choices. Communities understand political realities. They recognize threats. They can be partners in strategy rather than surprised bystanders to decisions that affect work they helped build.

Health equity benefits all communities. That includes white communities, rural communities, LGBTQ+ communities, working-class communities, and every other group facing barriers to achieving their highest level of health. Making that reality clear without watering down attention to racial health inequities represents the work ahead.

The false narrative of zero-sum competition for health resources must be challenged directly. Everyone can thrive. Enough resources exist. Narrowing health gaps does not require anyone to lose.

Building bridges across ideological divides requires strategic thinking about who carries which messages to which audiences. White health equity champions need to step into spaces where other advocates cannot safely go. That distribution of labor strengthens the overall movement.

Community engagement built on authentic partnership, co-equal relationships, shared governance, and bidirectional knowledge flow creates the foundation for sustainable change. Organizations need to remove institutional barriers that make this work harder than necessary.

The data shows more common ground exists than current political rhetoric suggests. Finding that common ground requires listening without agenda, building relationships for their own sake, and being willing to learn from people with different perspectives.

Health justice as both aspiration and operational framework offers a path forward. The process of authentic engagement produces outcomes that extend beyond any single goal. That process becomes the change advocates seek to create.

Resources

• AAMC Center for Health Justice: AAMCHealthJustice.org
• AAMC CHARGE (Collaborative for Health Equity Act Research Generate Evidence): Free membership open to health equity champions from all sectors. Visit AAMCHealthJustice.org for details.
• Principles of Trustworthiness Toolkit: Available through AAMC Center for Health Justice
• National Academies Model of Meaningful Engagement: Framework for authentic community partnership

This article was published on The Healthy Project Media website in October 2025. The content is based on a podcast interview between Corey Dion Lewis and Dr. Philip Alberti. All quotes and insights are used with permission.